A colleague is having surgery at your facility. Is it OK to play a prank on him, to paint his toenails red or to draw a cutesy tattoo on his chest?

"No way. It is a sign of profound disrespect, especially when someone is vulnerable," says Philadelphia orthopedic surgeon John D. Kelly IV, MD.

We agree with Dr. Kelly. But about 1 in 5 (21%) of the 245 readers we polled last month say sure, it's OK. Lighten up, he's one of us — it's all wink-wink-nudge-nudge good, clean fun. Pranking, some say, is a time-honored and common tradition of the OR, an almost expected consequence of letting friends and co-workers see you through your surgery.

"It's the unspoken rule: If you're willing to have surgery done where you work, you're willing to be part of the game," says Missouri anesthesiologist Alvin Manalaysay, PhD, MD. "If you don't like to have that done, go someplace else. If you can't have a little bit of fun, what's the point of going through life?"

Pranking came to light in May when a Texas appeals court ruled that 2 surgical nurses, their OR colleagues and their hospital should face trial for pranks played on a surgical tech as he underwent a tonsillectomy at the facility. Two RN co-workers who'd staffed the tech's case had a little fun while their colleague was under anesthesia. They applied pink nail polish to his fingers and toes. They wrote barb was here and kris was here on the soles of his feet and taped up his thumb to mock what court records described as his "very private, but embarrassing habit" of sucking it.

It didn't stop there. After the tech returned to work, the 2 RNs allegedly continued to tease him about the incident and spread misleading rumors about his sexual orientation, to the point that he left the hospital.

Dr. Manalaysay calls the nail polish and thumb taping "quite tame." He says he still laughs when he thinks back to the prank his pals played on him during his colonoscopy. They included in his medical record a photo of a gerbil inside a paper bag. The bag was crinkled and photoshopped to look like the inside of a colon.

"I think it's funny as hell," he says. "It's not something I'd enjoy on a daily basis, but for the one time when you are at the mercy of your colleagues, it is something you eventually start laughing about when you recall it."

Dr. Manalaysay recalls the prank played on a surgeon during his appendectomy. Before he woke up, they stuck a colostomy bag by his side. "He reaches to feel his side and sees this colostomy bag."

Dr. Manalaysay says he'd never prank a patient who wasn't a co-worker. "It's the old schoolyard thing: Don't just tickle some stranger. Tickle somebody you know." Here's a better idea, one sure to keep you out of trouble: Keep your hands to yourself.